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I can definitely see the connection between suicide and gate keeping. I'm not trans, but I do receive regular mental health care because I'm a combat veteran and deal with some trauma related to that and non-combat experiences alike. There's a real problem with "gatekeeping" at the VA when it comes to a lot of mental health diagnoses. Honestly, it should be considered a human right's issue. It sounds like they lump gender dysphoria in with the other stuff that they've decided we can live with. Except suicide rates say otherwise. I can only imagine how much more painful being denied treatment must be when your very identity (or how society identifies you, regardless of your feelings about it) is what causes you psychological harm.

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